Region Of Teeth Research Articles

Evaluation of CBCT reconstructed tooth models at different thresholds and voxels and their accuracy in fusion with IOS data: an in vitro validation study

BackgroundThis study aims to evaluate the impact of different thresholds and voxel sizes on the accuracy of Cone-beam computed tomography (CBCT) tooth reconstruction and to assess the accuracy of fused CBCT and intraoral scanning (IOS) tooth models using curvature continuity algorithms under varying thresholds and voxel conditions.MethodsThirty-two isolated teeth were digitized using IOS and CBCT at two voxel sizes and five threshold settings. Crown-root fusion was performed using a curvature continuity algorithm. Volume, surface area, and crown width of tooth models were compared to laser scanning models, and RMS error was measured. Data were analyzed using Wilcoxon signed-rank test, paired t-test, and one-way ANOVA.ResultsVolume amplification errors of CBCT with 0.15 mm and 0.3 mm voxels ranged from 1.22 to 19.07%, surface area errors from 0.18 to 7.78%, crown linearity errors ranged from 2.47 to 7.69%, root linearity errors ranged from − 1.02 to 2.26% and RMS from 0.0691 mm to 0.2408 mm. Crown-root fusion of IOS and CBCT data reduced volume error to -0.90–5.10%, surface area error to -0.66–4.15%, and RMS to 0.0359 mm to 0.0945 mm.ConclusionsVoxel size and threshold settings significantly affect the accuracy of CBCT reconstruction and crown-root fusion. Smaller voxel sizes yield higher reconstruction precision, and different voxel sizes and tooth regions correspond to distinct optimal segmentation thresholds. The validated semi-automated crown-root fusion algorithm significantly enhances overall model accuracy, offering new possibilities for clinical applications.

Assessment of the Peri-implant Bone Density Following Bicortical Anchored Corticobasal Implants Placement in the Maxillary Arch: A Cross-sectional Prospective Study.

The aim of this cross-sectional prospective study was to evaluate the bone density changes around the bicortical corticobasal implant placed in the maxilla over 18 months of follow-up using cone-beam computed tomography (CBCT), focusing on the comparison between the anterior and posterior teeth and regions. Thirty-five subjects (20, 53.26%, were males, and 15, 46.73%, were females) received 380 implants (Basal Cortical Screwable implant, BCS®) at Narsinhbhai Patel Dental College and Hospital, India. Implant survival and success were assessed using Albrektsson criteria for implant success. The peri-implant bone density values were measured using CBCT (Vatech PaX-i 3d Smart) and InVivo software (Anatomage, San Jose, California, USA) at the baseline (immediate postoperative) and at the 18-month follow-up visit. For standardization purposes, the bone density values for only the maxillary implants were measured at the level of the second implant thread in four sites: buccal, mesial, distal, and palatal, respectively. The recorded data were tabulated and grouped according to the tooth's region (anterior/posterior) and sites (mesial, distal, buccal, and palatal). The implant's survival rate was 100%. After 18 months, the bone density increased significantly (p < 0.05) in all the sites in both anterior and posterior regions. The study's findings revealed a higher bone density increase in the posterior region compared to the anterior region after 18 months of follow-up, except for the palatal site. Within the limitations of this study, an increase in the peri-implant bone density has been associated with the use of corticobasal implants over time, with reported anterior/posterior regional variations. This study provides valuable insights into the bone density changes associated with bicortical corticobasal implants and emphasizes the importance of CBCT in evaluating bone density, as well as the significance of regional considerations in implant dentistry. By integrating these findings into clinical practice, clinicians can improve treatment outcomes and ensure long-term implant survival. How to cite this article: Doshi A, Patel J, Gaur V, et al. Assessment of the Peri-implant Bone Density Following Bicortical Anchored Corticobasal Implants Placement in the Maxillary Arch: A Cross-sectional Prospective Study. J Contemp Dent Pract 2024;25(9):820-829.

Comparing the accuracy and treatment time of a robotic and dynamic navigation system in osteotomy and root-end resection: An invitro study.

To compare the accuracy and treatment time of a robotic system (RS) and a dynamic navigation system (DNS) in osteotomy and root-end resection in an invitro study. In this study, four identical mandibular models were created using three-dimensional (3D) printing, each model including 18 teeth. In the surgical procedures, teeth #35, #33, #32, #42, #43 and #45, along with the mesiobuccal roots of teeth #36 and #46, were specifically selected for operation on each model. Cone-beam computed tomography (CBCT) and intraoral scans were performed on all models. DentalNavi software was used to plan a drilling path and depth as well as design surgical accessories. In the RS, osteotomy and root-end resection were performed with robotic assistance, whereas in the DNS, these procedures were performed using dynamic navigation. Post-operative CBCT scans were obtained. Global platform deviation, global apex deviation, angular deflection, and time were compared to evaluate the accuracy and treatment time of the surgeries. The treatment time was defined as the registration time and drilling time. Statistical analyses were performed using the Shapiro-Wilk and independent sample t-test. The global platform deviation, global apex deviation and angular deflection in the RS group were significantly smaller than those in the DNS group (p <.05). The registration time in the RS group was significantly longer than that in the DNS group (p <.001), whereas the drilling time was significantly shorter (p <.001). The overall surgical time was significantly longer in the RS group than in the DNS group (p <.001). Subgroup accuracy analysis revealed that in both the anterior and posterior tooth regions, the RS group exhibited significantly smaller apical and angular deviations than the DNS group (p <.001). Additionally, in both the anterior and posterior tooth subgroups, the total time for the DNS group was significantly shorter than that for the RS group in the anterior tooth area (p <.01). RS showed higher accuracy and shorter drilling time in osteotomy and root-end resection compared to DNS. The RS holds promise as a reliable technological advancement in endodontic microsurgery. However, future endeavours should prioritize the reduction in registration time.

Enhanced Panoramic Radiograph-Based Tooth Segmentation and Identification Using an Attention Gate-Based Encoder-Decoder Network.

Dental disorders are one of the most important health problems, affecting billions of people all over the world. Early diagnosis is important for effective treatment planning. Precise dental disease segmentation requires reliable tooth numbering, which may be prone to errors if performed manually. These steps can be automated using artificial intelligence, which may provide fast and accurate results. Among the AI methodologies, deep learning has recently shown excellent performance in dental image processing, allowing effective tooth segmentation and numbering. This paper proposes the Squeeze and Excitation Inception Block-based Encoder-Decoder (SE-IB-ED) network for teeth segmentation in panoramic X-ray images. It combines the InceptionV3 model for encoding with a custom decoder for feature integration and segmentation, using pointwise convolution and an attention mechanism. A dataset of 313 panoramic radiographs from private clinics was annotated using the Fédération Dentaire Internationale (FDI) system. PSPL and SAM augmented the annotation precision and effectiveness, with SAM automating teeth labeling and subsequently applying manual corrections. The proposed SE-IB-ED network was trained and tested using 80% training and 20% testing of the dataset, respectively. Data augmentation techniques were employed during training. It outperformed the state-of-the-art models with a very high F1-score of 92.65%, mIoU of 86.38%, and 92.84% in terms of accuracy, precision of 92.49%, and recall of 99.92% in the segmentation of teeth. According to the results obtained, the proposed method has great potential for the accurate segmentation of all teeth regions and backgrounds in panoramic X-ray images.

Ultrasonographic Evaluation of Vascular Response to Mechanical Compression during Induced Gingival Inflammation

The aim of this study was to evaluate the gingival vascular response to mechanical compression during inflammation using ultrasonography. Four female and 4 male Sinclair mini pigs 18 mo of age were included in the study. Pathogenic bacteria–impregnated silk ligatures were placed around the third premolars (PM3), fourth premolars (PM4), and first molars (M1). Ligatures were placed per quadrant at 2-wk intervals in random order. Ultrasonographic study was performed at 2-wk intervals following baseline until the 10th week. Brightness mode (B-mode) images and color flow cine loops were captured at 2 different conditions: 1 with only coupling gel between the ultrasound transducer and the mucosal surface and 1 with the transducer compressing the mucosal surface. The compression was visually adjusted until minimal to no blood flow was detected in color-flow mode. Compression was facilitated using a solid gel pad attached to the transducer. Strain values were obtained from B-mode images of the gel pad and plotted versus study weeks. The t test comparisons were obtained to the baseline (week 0). Data from female and male pigs were plotted and analyzed separately for comparison. Gel pad strain increased with peak around week 4 and gradually decreased in both sexes. In male pigs, the increase in strain was statistically significant in weeks 2, 4, and 6 of all teeth regions and week 8 of PM4 and M1 regions. In female pigs, the increase in strain was significant in only week 4 of PM4. Higher strain required for stoppage of blood flow implies increased gingival blood flow with inflammation, which corresponds with previous studies. Considerably smaller changes in gel pad strain were noted from female pigs, indicating a smaller increase in gingival blood flow compared with males. This study demonstrated a possible application of intraoral ultrasonography for assessment of gingival inflammation.

Analysis of stress distribution in implant-supported prostheses with custom abutments at different angles of 20 degrees: A finite element analysis

Aim: Implants may not always be placed parallel to each other. In such cases, implants can be made more parallel by adjusting the angles with custom abutments. Different cementation materials can be used for cement-retained abutments. The bonding and stress resistance values of materials used in the cementation of implant-supported prostheses vary. The aim of this study is to demonstrate the stress distribution values of restorations bonded with different cementation materials in finite element analysis. Methodology: In this study, a maxillary edentulous jawbone was designed using the SolidWorks program. Two implants were placed in the regions of teeth #14 and #16. Implant data was obtained from the Bilimplant company. A 20-degree angled custom abutment and implant-supported prosthesis were designed using the Exocad program. Standard Tesellation Language (STL) files were transferred to SolidWorks to obtain Standard for the Exchange of Product Model Data (STP) files. The created prosthesis design was then transferred to the ABAQUS program for finite element analysis. Subsequently, using 5 different cementation materials (glass ionomer cement, dual-cure resin cement - ivoclar, dual-cure resin cement - relyx, polycarboxylate cement, self-cure resin cement), stress distribution values of implant-supported prosthesis components were recorded as von Mises stress values (VMS) Results: İndicate higher stress values with glass ionomer cement and lower with polycarboxylate cement. Stress distribution increases posteriorly but doesn't significantly differ based on cement type. Lowest stress on implant screws is with glass ionomer, but highest varies. Cortical bone stress is lowest with glass ionomer cement. Conclusion: There was no significant difference in stress values among different cement types. Stress increases in implants, abutments, and cements due to forces applied posteriorly, while anteriorly, retention screw stress increases. The choice of cementation material does not significantly impact stress in implant components or surrounding tissues.

Non-Neoformans Cryptococcal Infections in the Post-Coronavirus Disease-19 (COVID-19) Era: Are We Ready to Face the Emerging Challenge?

AbstractCoronaviruses are a large group of viruses that infect animals as well as humans, while it is also suggested that, rarely, coronaviruses that infect animals can evolve and infect humans. Current evidence suggests that severe acute respiratory syndrome (SARS) coronavirus-2 leads to coronavirus disease-19 (COVID-19), the respiratory illness responsible for COVID-19 pandemic, while it has a zoonotic origin, closely related to the bat-origin SARS-like coronavirus. Also, as per the current knowledge, the disease may induce significant and persistent lymphopenia which in turn may increase the risk for various opportunistic infections. Cryptococcus laurentii is one such rare, but serious fungal infection which has been reported in post-COVID-19 disease and is a rising cause of concern since it can turn out to be fatal. The infection is caused by a non-neoformans rare human pathogen. The present case report describes the case of a 45-years old male patient who reported to the Outpatient Department (OPD) for a routine dental complaint with a grossly destructed tooth in left lower back tooth region due to extensive carious involvement, while, simultaneously, presenting with fever since 5 days in the post-COVID-19 phase, and was later diagnosed as being positive for C. laurentii infection on urine culture sensitivity test.

Periapical cemento-osseous dysplasia masquerading as asymptomatic chronic apical periodontitis in a Chinese woman: A case report.

Cemento-osseous dysplasia (COD) belongs to a group of fibrous osseous disorders that can masquerade as periapical inflammatory conditions in the jawbones. We present a rare case of COD occurring in a patient who also had periapical periodontitis concurrently. When faced with a patient exhibiting no symptoms, diagnosis may be challenging. COD is a fibrous osseous disorder similar to periapical chronic inflammatory conditions and other cysts in the jaw bones on the radiograph. There is a rare case of COD occurring in a 49-year-old Chinese woman who also had chronic periapical periodontitis concurrently. The lesions were incidentally discovered in the mandibular anterior tooth region during the patient's imaging examination. The patient exhibited no symptoms, and diagnosing the conditions may be challenging due to the confusingly similar radiological features that present as a radiolucent lesion in the periapical region. The final diagnosis was made through pulp vitality tests, cone beam computed tomography (CBCT), and clinical examinations. The COD was recommended for annual follow-up. Root canal therapy has been performed for chronic apical periodontitis. According to the diagnostic process of COD, a thorough history check, multiple clinical examinations, and imaging studies should be emphasized to prevent misdiagnosis and avoid unnecessary or inappropriate therapies. The patient was followed up for 6 years. The recovery of chronic apical periodontitis in tooth #31 and the transformation of osteolytic and osteogenesis of COD had been observed in CBCT.

Prevalence of gingival overgrowth among patients at the periodontology clinic of Dental Hospital Universitas Airlangga

Background: The prevalence of dental and oral health problems in Indonesia, including periodontal disease and gingival overgrowth (GO), remains high and requires serious attention from health workers. This study aims to determine the prevalence of GO due to the existing data gap and public concern regarding this condition. Objectives: To determine the prevalence of gingival overgrowth among patients at the periodontology clinic of Universitas Airlangga Dental Hospital. Material and Methods: This study was conducted from August to September 2023 at the Dental and Oral Hospital (RSGM) Universitas Airlangga using a descriptive observational method with a cross-sectional design. The sample was calculated using total sampling from medical record data of patients at the Periodontics Clinic of the Dental and Oral Hospital (RSGM) Universitas Airlangga who met the inclusion criteria in 2022. The study variables included gingival overgrowth (GO), gender, age, and tooth region (sextant). Data were processed using Microsoft Excel and presented as a percentage (%). A descriptive data analysis was carried out to draw a conclusion. Conclusion: The study found that 37.11% of patients at the Dental and Oral Hospital (RSGM) of Universitas Airlangga experienced gingival overgrowth. The percentage of male patients experiencing gingival overgrowth was higher than that of women, with the highest age group being 18-24 years. The tooth area that experienced the most gingival overgrowth was sextant 5, with a total of 29 samples.

Complication rates of guided bone regeneration using titanium-reinforced PTFE membranes: a retrospective analysis.

This study analyzed complication rates of guided bone regeneration (GBR) using titanium-reinforced polytetrafluoroethylene (PTFE) membranes for alveolar ridge augmentation. 84 patients treated with GBR using titanium-reinforced PTFE membranes (91 sites) were retrospectively analyzed. Complications such as membrane exposure and early removal were analyzed concerning patient age, defect site position, size, simultaneous vs. two-stage implant placement, smoking, and the use of bone grafts (BG) and substitutes (BS). Early removal due to membrane exposure was necessary in 14/91 sites (15.4%). No correlation was found between early removal and patient age (p = 0.917). Analyzing early removal between the upper and lower jaw and between both jaws' anterior and posterior tooth regions revealed no correlations (p = 0.381 and 0.477, respectively). Defect sites sizes of 5-6mm exhibited the highest rate of membrane exposure, requiring early removal, accounting for 57.1% of these sites (8/14). No correlation was observed between the defect sites size and early removal (p = 0.660). Comparison of simultaneous (74 sites) vs. two-stage implant placement (16 sites) showed no correlation with early removal (p = 0.706). Membrane exposure incidence was 42.9% among smokers (27 patients, 32.1%) and 57.1% among non-smokers (57 patients, 67.9%), without correlation. No correlation was found between the type of BG and BS and early removal (p = 0.500). GBR using titanium-reinforced PTFE membranes is effective for alveolar ridge augmentation and has favorable long-term outcomes. Careful surgical technique and postoperative care can minimize the notable risk of PTFE membrane exposure.

Evaluation of hard tissue characteristics and calcifications in pulp tissue of hypomineralized permanent molars using micro-computed tomography

ObjectivesTo determine and compare pulp volume, dentin mineral density, presence of microcracks, pulp stones, and accessory canals, as well as their localizations in root regions for hypomineralized and healthy teeth. DesignThis study included 60 extracted permanent molar teeth, categorized into hypomineralized and healthy groups (n = 30 each). The hypomineralized group comprised molar teeth with limited white, yellow, or brown opacities, post-eruptive breakdown, or extensive restoration or crown damage. The healthy group included caries-free molar teeth without these characteristics. Using 3D micro-computed tomography images pulp volume, dentin mineral density, and the presence and locations of microcracks, pulp stones, and accessory canals were determined for each group. Statistical analyses were conducted using Independent T-test and Chi-square test, with significance set at p < 0.05. ResultsThere was no statistically significant difference between the groups regarding pulp volume and microcracks (p ≥ 0.05). The number of accessory canals was significantly greater in the cervical (p = 0.011; p < 0.05) and middle (p = 0.010; p < 0.05) regions of the hypomineralized teeth than healthy teeth. Dentin mineral density was statistically higher in the apical, middle, and cervical root regions (p < 0.001; p < 0.05); however, the number of pulp stones was found to be greater in the cervical regions of healthy teeth compared with those with hypomineralization (p = 0.026; p < 0.05). ConclusionThere were lower dentin mineral density measurements, a decreased number of pulp stones in the cervical region, and a greater number of accessory canals in the middle and cervical regions of hypomineralized teeth compared with healthy teeth.

Simple bone cyst of the mandible: A case report with review of literature

Simple bone cyst (SBC) was first described by Lucas in 1929. It is an asymptomatic, intraosseous cyst. It falls under pseudocyst category, as it is devoid of an epithelial lining and mostly discovered accidently on routine radiograph. It commonly affects metaphyses of long bones such as humerus and femur. Other terminologies used for this lesion include Solitary bone cyst, traumatic bone cyst and hemorrhagic bone cyst. The incidence of cyst affecting the jaws is only 1%. About 89% of the lesion occurs in mandible and 11% in maxilla. The purpose of this article is to present rare occurrence of SBC in the mandibular region with review of literature. An 18 year old male patient reported with pain in right lower back teeth region. Clinically 47 was tender. Panoramic radiograph showed a radiolucent unilocular lesion in ascending ramus and mandibular body distal to 47. Diagnosis of apical periodontitis in relation to 47 and simple bone cyst mandible was made by correlating clinical, radiographic and histopathological evaluation. Surgical curettage was performed and follow up after 4 months revealed no evidence of recurrence. Simple bone cyst is rare incidental lesion of the mandible. Thorough clinical, radiological and histopathologic evaluation is helpful for diagnosis and surgical management of the lesion. Conservative management should be approached to prevent noble structure, with follow up to confirm remission of the lesion.

Accuracy of imaging software usable in clinical settings for 3D rendering of tooth structures.

The aim of the present study was to evaluate the segmentation accuracy of the dentition by testing four open-source semi-automatic software programs. Twenty CBCT scans were selected to perform semi-automatic segmentation of the maxillary and mandibular dentition. The software programs tested were InVesalius, ITK-SNAP, 3D Slicer, and Seg3D. In addition, each tooth model was manually segmented using Mimics software; this was set as the gold standard (GS) reference of the investigation. A specific 3D imaging technology was used to perform the superimposition between the tooth models obtained with the semi-automatic software and the GS model as well as to perform the surface-to-surface matching analysis. The accuracy of semi-automatic segmentation was evaluated, calculating the volumetric mean differences (mean bias and limits of agreement) and the percentage of matching of the tooth models compared with the manual segmentation (GS). Qualitative assessments were performed using color-coded maps. All data were statistically analyzed to perform comparisons between the investigated software programs. Statistically significant differences were found in the volumetric and matching percentage data (P 0.05). InVesalius was the most accurate software program for 3D rendering of the dentition, with a volumetric bias (Mimics software) ranging from 4.59 to 85.79 mm3, while ITK-SNAP showed the highest volumetric bias, ranging from 30.22 to 319.83 mm3. The mismatched area was mainly located at the radicular tooth region. The volumetric data showed excellent inter-software reliability, with coefficient values ranging from 0.951 to 0.997. Different semi-automatic software algorithms could generate different patterns of inaccuracy error in the segmentation of teeth.

Anatomy and function of the canalis sinuosus and its injury prevention and treatment strategies in implant surgery

The canalis sinuosus, a canal containing the anterior superior alveolar nerve bundle, originates from the infraorbital canal and extends along the maxillary sinus and nasal cavity edges to the anterior maxilla. It was once regarded as an anatomical variation. However, with the widespread application of cone beam computed tomography (CBCT), the detection rate of canalis sinuosus in the population has increased. The canalis sinuosus exhibits diverse courses, branching into multiple accessory canals and terminating at the nasal floor or the anterior tooth region, with the majority traversing the palatal side of the central incisor. The anterior superior alveolar nerve bundle within the canalis sinuosus not only innervates and nourishes the maxillary anterior teeth and the corresponding soft tissues, and the maxillary sinus mucosa, but also relates to the nasal septum, lateral nasal wall, and parts of the palatal mucosa. To minimize surgical complications, strategies for preventing and treating canalis sinuosus injuries need to be investigated. Preoperatively, CBCT is used to identify the canalis sinuosus and to virtually design implant placement at a distance of more than 2 mm from the canalis sinuosus. Intraoperatively, assessing bleeding and patient comfort, complemented by precision surgical techniques such as the use of implant surgical guide plates. Postoperatively, CBCT is used to examine the relationship between the implant and the canalis sinuosus, and treatment of canalis sinuosus injuries can be tailored based on the patient's symptoms. This review summarizes the detection of canalis sinuosus in the population, its anatomical characteristics, and the physiological functions in the anterior maxilla, and discusses strategies for avoiding canalis sinuosus injuries during implant surgery, thereby enhancing clinical awareness and providing references for clinical decision-making.

Accuracy of polyether and vinylpolysiloxane impressions when using different types of 3D-printed impression trays - an in vitro study.

To investigate dimensional accuracy of polyether (PE) and vinylpolysiloxane (VPS) impressions taken with manually fabricated and 3D-printed trays. To evaluate impression accuracy, highly precise digital data of a metallic lower jaw model with prepared teeth (regions 34 and 36), an implant (region 47) and three precision balls placed occlusally along the dental arch served as reference. PE (Impregum, 3M Oral Care) and VPS (Aquasil, Dentsply Sirona) impressions (n = 10/group) were taken with trays fabricated using different materials and manufacturing techniques (FDM: filament deposition modeling, material: Arfona Tray, Arfona; printer: Pro2, Raise3D; DLP: digital light processing, material: V-Print Tray, VOCO, printer: Max, Asiga; MPR: manual processing with light-curing plates, material:LC Tray,Müller-Omicron) including an open implant impression. Scans of resulting stone models were compared with the reference situation. Global distance and angular deviations as well as local trueness and precision for abutment teeth and scan abutment were computed. Possible statistical effects were analyzed using ANOVA. Clinically acceptable global accuracy was found (all mean absolute distance changes < 100μm) and local accuracy for single abutments was excellent. All factors (abutment type, impression material, tray material) affected global accuracy (p < 0.05). In particular with PE impressions, MPR trays led to the best accuracies, both in horizontal and vertical direction. Within the limitations of this in vitro study, impression accuracy was high in use of both polyether and vinylpolysiloxane combined with different 3D-printed and customized trays making them recommendable for at least impressions for smaller fixed dental prostheses. Manually fabricated trays were overall still the best choice if utmost precision is required. Based on the results of this study, use of innovative CAD-CAM fabrication of individual impression trays fulfills the perquisites to be a viable option for impression making. In the sense of translational research, performance should be proved in a clinical setting.

Evaluation of microleakage of mineral trioxide aggregate and biodentine as apical barriers in simulated young permanent teeth

BackgroundApexification is a procedure that promotes apical closure by forming mineralized tissue in the apex region of a nonvital young permanent tooth. Calcium silicate-based cement like Mineral trioxide aggregate (MTA) and Biodentine are commonly employed as apical barriers to facilitate this process. Microleakage, defined as the leakage along the junction between the canal wall and filling material, is a crucial aspect to assess in MTA and Biodentine applications as apical barriers, as it directly impacts the prevention of bacterial seepage and maintenance of structural integrity. The current study aims to assess the microleakage of MTA and Biodentine when used as apical barriers in simulated young permanent teeth.MethodsFrom a total of 128 extracted teeth, 114 were selected for the study and randomly allocated into three groups: G1 (MTA), G2 (Biodentine), and G3 (Control), with 38 teeth per group. After excluding 5 teeth from each group due to issues such as canal calcification, breakage during sectioning, and procedural errors, 33 teeth were analyzed to ensure equal distribution. To simulate young permanent teeth, samples were instrumented using a person-reamer with a diameter of 1.7 mm. A 4 mm thick apical plug of MTA and Biodentine was placed in G1 and G2, respectively, while G3 was the control group. Apical microleakage in all experimental groups was assessed using a dye penetration method. Specimens were longitudinally sectioned and examined under a stereomicroscope with graded eyepiece.ResultsThe Kruskal-Wallis test revealed variations in mean apical microleakage among the groups: G1 recorded 0.67, G2–0.16, and G3–1.62, with G2 showing the lowest value and G3 group exhibiting the highest.ConclusionsBiodentine was found to excel in its ability to create a secure seal and function effectively as an apical barrier in simulated young permanent teeth. These results underscore its potential as a highly efficient material for dental applications, particularly in scenarios requiring reliable sealing and barrier formation in the root canal system of developing permanent teeth.

Overhauling dental implications in a child with rare craniofrontonasal syndrome: a case report

Craniofrontonasal syndrome is an extremely rare X-linked dominant genetic disorder characterized by features such as hypertelorism, craniosynostosis, ocular anomalies, a bifid nasal tip, and longitudinal ridging with splitting of the nails. Heterozygous females are more severely affected, presenting frontonasal dysplasia and coronal craniosynostosis (fusion of the coronal sutures), while males typically only exhibit hypertelorism. This case report describes the dental management of a 9-year-old female with craniofrontonasal syndrome who was referred to the department of paediatric and preventive dentistry for pain in the lower right and left back tooth region. The patient exhibited a clinical spectrum including microcephaly, short neck, axillary pterygium, clinodactyly of the toes, longitudinal ridging with split nails, pectus excavatum, and underdeveloped female genitalia. Extraoral examination revealed hypertelorism, flat nasal bridge, low-set ears, strabismus, antimongoloid slant, and an indistinct philtrum. Intraoral examination showed a high palatal vault, crowding of the upper and lower arches during the mixed dentition period, multiple dental caries, and poor oral hygiene. An orthopantomogram confirmed delayed dental development. Dental treatment was carried out on a dental chair system using adequate behaviour management techniques with short appointments, keeping in mind the reduced cooperative ability of the child. The importance of this report stems from the limited dental literature available on the syndrome. Preventive measures along with home care instructions were emphasized to support professional care.

Assessment of changes in enamel colour following fixed orthodontic therapy using an advanced spectrophotometer: An in vivo study.

Any manipulation of the surface of natural teeth may result in a variation of their colour. The fixed orthodontic treatment (FOT) is one such procedure which alters the enamel surface during the procedure. To clinically evaluate the colour changes in teeth associated with comprehensive FOT (to compare the changes in test and control groups) and to determine the relationship of age and gender on enamel colour due to FOT by using an advanced spectrophotometer. The selection of sixty patients for the study was done randomly and among these thirty patients who underwent the FOT as the case group, the other thirty patients who did not need FOT, were the control group. The recordings of spectrophotometric data were done in a standardized manner for all patients in the labial circular region of every anterior tooth, following debonding and cleaning operations, and before bracket bonding. The Commission Internationale de l'Eclairage's L*, a*, and b* (lightness, red/green, and blue/yellow) tooth-type characteristics were used to measure color, and the associated color differences (DE) between the groups were computed. One-way ANOVA (a < 0.05) and the paired t-test were used to evaluate any changes in these color characteristics. Fixed orthodontic treatment is associated with changes in colour parameters. L* values decreased (P< 0.001), while a* and b* values increased (P< 0.001) at the end of treatment. All measured tooth types showed significant colour change (DE); their mean differences ranged from 1.64 to 2.96 DE units. Fixed orthodontics can change the natural colour of teeth. The CIE colour parameters L*, a*, and b* of natural teeth showed statistically significant differences after debonding the orthodontic appliances. The L* values decreased making the teeth look darker. The adolescent and male patients had more tooth colour changes than the adult and female groups.

Radular Tooth Coating in Members of Dendronotidae and Flabellinidae (Nudibranchia, Gastropoda, Mollusca).

Nudibranchs, with their mesmerizing diversity and ecological significance, play crucial roles in marine ecosystems. Central to their feeding prowess is the radula, a chitinous structure with diverse morphologies adapted to prey preferences and feeding strategies. This study focuses on elucidating wear coping mechanisms in radular teeth of carnivorous molluscs, employing Dendronotus lacteus (Dendronotidae) and Flabellina affinis (Flabellinidae) as model species. Both species forage on hydrozoans. Through scanning electron microscopy, confocal laser scanning microscopy, nanoindentation, and energy-dispersive X-ray spectroscopy, the biomechanical and compositional properties of their teeth were analyzed. Notably, tooth coatings, composed of calcium (Ca) or silicon (Si) and high hardness and stiffness compared to the internal tooth structure, with varying mineral contents across tooth regions and ontogenetic zones, were found. The presence of the hard and stiff tooth coatings highlight their role in enhancing wear resistance. The heterogeneities in the autofluorescence patterns related to the distribution of Ca and Si of the coatings. Overall, this study provides into the biomechanical adaptations of nudibranch radular teeth, shedding light on the intricate interplay between tooth structure, elemental composition, and ecological function in marine molluscs.

Analysis of tooth staining by endodontic medication in root canal therapy using spectrophotometry.

The assessment of the discoloration caused by calcium hydroxide, triple antibiotic paste, and chlorhexidine gel when used as intra-canal medicaments in teeth undergoing root canal treatment is of interest. The study measured the discoloration over seven and fourteen days using a spectrophotometer. After obtaining ethical clearance, ninety anterior teeth requiring root canal therapy were selected based on eligibility criteria. Using basic randomization, participants were split up into three groups, each consisting of thirty patients. The colorimeter was used to measure preoperative, one and two weeks following the medication's removal. All groups showed significant discoloration, with 2% chlorhexidine gel (p≤0.03) and triple antibiotic paste (p≤0.02) causing the highest discoloration in the central region of teeth. The discoloration was inversely correlated with the remaining dentin thickness. Thus, intracanal medicaments used for endodontic treatment cause tooth discolouration.